History Of Previous Treatment Research Articles

Predicting The Course Of Localized Periodontitis Of Traumatic Etiology After Complex Treatment

Due to the noteworthy prevalence of inflammatory periodontal diseases among the population, especially in older age groups, the problem of providing timely and quality care to prevent severe complications leading to tooth loss becomes urgent. Conventional approaches to treatment are not always successful and do not necessarily provide a lasting effect. Therefore, predicting the outcome of the disease is a critical task. Material and Methods — We performed examination of 169 individuals and treatment of 126 patients aged 45-75 years with mild to moderate localized periodontitis of traumatic etiology (LPT) were performed. We employed clinical, radiological, and functional methods of examining periodontal condition, and investigated laboratory blood parameters (complete blood count, C-reactive protein). To assess the body’s adaptive resources, the entropy of the leukocyte blood count was calculated, and risk factors for the occurrence of LPT were assessed. Predicting the course of LPT based on changes in clinical and radiological indicators was accomplished by assessing treatment outcomes and calculating a prognostic score. Results — Patients exhibited a noteworthy prevalence of somatic pathology, with cardiovascular diseases (RR=2.32), anemia (RR=2.26), and gastrointestinal tract disorders (RR=1.88) emerging as predominant conditions (p<0.001). The duration of the disease exceeding three years was associated with a 2.06-fold increase in the risk of developing moderate-grade LPT (p=0.017). With a concentration of C-reactive protein in the range of 3-10 mg/L, the risk of developing moderate-grade LPT increased 1.74-fold (RR=1.74; p=0.0022). The intense type of adaptive reaction of the body was detected in 30.4% and 50.7% of cases with mild and moderate grades of LPT, respectively, increasing the risk of a more severe grade by 1.8 times (p=0.0026). Pronounced local changes in the bone tissue of the alveolar process were observed 1.6-2 times more often in cases of moderate periodontitis vs. mild LPT (p=0.0035). Microcirculation in the inflammation zone decreased by 32% and 50.1% with mild and moderate grade of the disease, respectively (p<0.001). Splinting of teeth in the area of the pathological focus during treatment led to improved clinical indicators vs. the control group (p=0.012). Conclusion — Based on the study results, the prognosis for the course of LPT was most significantly influenced by the following factors: the concentration of C-reactive protein, the grade of LPT, the entropy of the leukocyte blood count, changes in the alveolar bone of the jaw, the duration of the disease, the history of previous periodontal treatment, and tooth splinting. Calculation of a prognostic score for the treatment outcome of LPT allows to qualitatively assess the clinical situation and identify a group at risk of an adverse treatment outcome.

Abstract 2388: Artificial neural network based ensemble models for single-arm glioblastoma trials: A new historical control adjustment method

Abstract Background: Despite a long history of poor decision making leading to repeated failed phase 3 trials, phase 2 single-arm studies continue to be common in glioblastoma (GBM). With the drawback of inflated false positive rate in current adjustment method for historical control data as concurrent controls, the new statistical methods and validation approach will be needed for adequate covariate adjustment in the GBM single-arm trial data. Methods: The systematic review was performed to extract the summary-level external data of survival outcomes (mean progression-free survival, mPFS, and PFS at 6 months, PFS6) and prognostic factors (age, gender, extent of resection, KPS, methylation status, and treatment history) from published randomized clinical trials for the standard of care (SOC) treatment in GBM. Four models of the standard, bootstrap aggregating, random subspaces, and random patches models were developed to construct a powerful predictive tool by comprising a series of connections producing survival outputs as a function of prognostic inputs using (1) artificial neural network (ANN) method and (2) linear method (Fig1). The root mean square errors (RMSEs) were calculated to evaluate the model performance using the five-fold cross-validation approach with the effects of ensemble size. The predictive survival outcomes among prognostic factors were calculated to evaluate the relative importance of factors. Results: We identified 19 Phase 2 and 3 clinical trials in glioblastoma and two survival outcomes and seven prognostic factors (Table 1). ANN models have less prediction error and therefore better performance on the test set than linear models. Presumably, the relationships in the data are highly nonlinear, and thus linear models cannot capture these relationships (Table 2). Bagging models typically outperform their standard counterparts for both ANNs and linear models. Ensemble methods can capture many trends within the data by manipulation of the training set and are therefore less prone to biases of individual models exacerbated by the small sample size. The previous treatment history and methylation status were the top two influential prognostic factors for both mPFS and PFS6, followed by the extent of resection and mean age (Fig2). With the examination of the ANN parameters of sample size, learning rate, training hyperparameters, it could be observed that there is no clear change in error when increasing sample size beyond 10 (Fig3). Conclusions: High failure rate of phase 3 glioblastoma trials emphasizes the need for greater reliability of earlier studies in phase 2 single-arm trials. The proposed statistical and epidemiologic approach based on the ensemble-based ANN models will be an effective tool to lead to better decision with phase 2 single-arm trials, which may give better chance to appropriately advance to phase 3 trials with higher predictive power. Citation Format: Wonsuk Yoo, Tortsen Ullrich, Nader Sanai. Artificial neural network based ensemble models for single-arm glioblastoma trials: A new historical control adjustment method [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2388.

HUMAN CYSTIC ECHINOCOCCOSIS IN ENDEMIC REGIONS IN BULGARIA - ULTRASOUND SURVEILLANCE, TREATMENT AND FOLLOW-UP OF PATIENTS

Introduction: Cystic echinococcosis (CE) is a chronic disease in humans, usually asymptomatic, but in some cases could be very severe with fatal outcomes. This parasitosis is a health and economic problem in many areas of the world. The actual spread among people with CE in endemic regions is not known. The purpose of prophylactic ultrasound examinations of people in some areas was to clarify the real prevalence of CE and to detect undiagnosed asymptomatic cases and recurrences. Materials and methods: An abdominal ultrasound survey in four endemic regions in Bulgaria with the highest rate of registered patients with CE in Bulgaria for the last five years was conducted. For every patient with CE an epidemiological and clinical history, abdominal ultrasound examination, blood tests and ELISA IgG test for CE were performed. Results: From all 8602 people examined, in seventeen persons (0.2%), liver hydatid cysts were found for the first time. Ssixty five (0.8%) reported a history of previous surgical treatment for CE, of which 54 (83.1%) had passed surgery because of liver CE and 11 (16.9%) had extrahepatic CE (pulmonary, cardiac, bone, spleen). In three (5.6%) patients, who were operated years before for liver CE, recurrences were discovered. In 11 (64.7%) patients devitalized CE4 cysts were observed without any data for previous treatment. Three of the discovered patients with CE were treated with surgery, one with puncture-aspiration-injection-reaspiration, four only with Albendazole. The patients were successfully treated and followed for a period of five years. Conclusions: During the prophylactic ultrasound examinations, a higher percentage of people infected with liver cystic echinococcosis was found compared to the official information. It should be noted that these results are found in areas with the highest incidence of this disease in the country. US screenings give the opportunity for early detection, timely treatment of infected people and to prevent severe complications in patient with CE disease.

DRUG AND ALCOHOL USE IN ORTHOPAEDIC TRAUMA PATIENTS: A PROSPECTIVE STUDY

The objective of this study is to prospectively investigate the prevalence, patterns, and correlates of drug and alcohol use among orthopaedic trauma patients. After the ethical approval from the institutional review board, this cross-sectional study was conducted at Jinnah Postgraduate Medical Center from 01/09/23 to 29/02/24. Baseline data was collected upon admission and included demographic information (such as age and gender) and a comprehensive assessment of substance use history. Substance use was assessed using validated screening tools, including the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Abuse Screening Test (DAST), to capture patterns of alcohol and drug use, frequency, duration, and any previous treatment history for substance use disorders. In the present study, the prevalence of drug and alcohol use among the orthopedic traumatic participants was (40%). Among them, the majority (51%) were using alcohol, followed by marijuana use (25%), and then cocaine (11%). The means of hospital stay of participants in substance non-users and users (2.4±0.8 vs. 6.83±1.1; P<0.0001). Pre-injury alcohol and drug use appear to correlate with extended hospital stays among patients with traumatic orthopaedic injuries.

To study the profile of multi-drug resistant tuberculosis (MDR) TB patients on shorter regimen at a tertiary care Centre of North India

The effectiveness of shorter regimen for the treatment of MDR-TB patients was found in the study done by Damien Foundation in Bangladesh, therefore we planned to study the profile MDR-TB patients who were taking shorter regimen so that various factors can be explored related to this regimen in Indian scenario.This was a prospective longitudinal study done in respiratory medicine department between January 2020 to December 2021. There were 177 patients of MDR/ RR pulmonary TB were identified and as per inclusion criteria and based on exclusion criteria 84 patients were excluded therefore our study population comprised of 93 remaining patients those who filled the study protocol, their treatment (Injectable shorter regimen ) and follow up investigations done as per programmatic management of drug resistant TB guideline of National TB elimination programme. There were 55(59%) males and 38(41%) were females and mean age of patient was 31±15.11 years (range 4-82 years). Out of 93 patients 27(29%) were smokers and 25(27%) were alcoholics and the most common symptom was fever 92(98.9%). The most common comorbidity was diabetes mellitus 11(11.9%). The most common minor side effect seen was GI intolerance in 41(44.1%) patients.Out of 93 patients 76.3% (71) were cured and 23.7% (22) patients were failed to cure. The association between smoking and treatment outcome was statistically significant (p value=0.013). The association between treatment outcome and previous history of adequate treatment was found to be significant (p=0.016).

Spatial pattern of isoniazid-resistant tuberculosis and its associated factors among a population with migrants in China: a retrospective population-based study.

Isoniazid-resistant, rifampicin-susceptible tuberculosis (Hr-TB) globally exhibits a high prevalence and serves as a potential precursor to multidrug-resistant tuberculosis (MDR-TB). Recognizing the spatial distribution of Hr-TB and identifying associated factors can provide strategic entry points for interventions aimed at early detection of Hr-TB and prevention of its progression to MDR-TB. This study aims to analyze spatial patterns and identify socioeconomic, demographic, and healthcare factors associated with Hr-TB in Shanghai at the county level. We conducted a retrospective study utilizing data from TB patients with available Drug Susceptible Test (DST) results in Shanghai from 2010 to 2016. Spatial autocorrelation was explored using Global Moran's I and Getis-Ord statistics. A Bayesian hierarchical model with spatial effects was developed using the INLA package in R software to identify potential factors associated with Hr-TB at the county level. A total of 8,865 TB patients with DST were included in this analysis. Among 758 Hr-TB patients, 622 (82.06%) were new cases without any previous treatment history. The drug-resistant rate of Hr-TB among new TB cases in Shanghai stood at 7.20% (622/8014), while for previously treated cases, the rate was 15.98% (136/851). Hotspot areas of Hr-TB were predominantly situated in southwestern Shanghai. Factors positively associated with Hr-TB included the percentage of older adult individuals (RR = 3.93, 95% Crl:1.93-8.03), the percentage of internal migrants (RR = 1.35, 95% Crl:1.15-1.35), and the number of healthcare institutions per 100 population (RR = 1.17, 95% Crl:1.02-1.34). We observed a spatial heterogeneity of Hr-TB in Shanghai, with hotspots in the Songjiang and Minhang districts. Based on the results of the models, the internal migrant population and older adult individuals in Shanghai may be contributing factors to the emergence of areas with high Hr-TB notification rates. Given these insights, we advocate for targeted interventions, especially in identified high-risk hotspots and high-risk areas.

Loss to follow-up: Understand its determinants among tuberculosis patients, in Coimbra District (2005–2017)

IntroductionTuberculosis patients who abscond from treatment are more likely to contribute to ongoing transmission. This growing concern has led to the development of this study in order to assess risk factors among Tuberculosis patients lost to follow up (LTFU) notified in the Coimbra District between 2005 and 2017. Material and methodsA case-control study was designed to compare Tuberculosis patients LTFU (cases) to those successfully treated (controls). Forty-two LTFU cases were compared to 712 controls. Social and demographic data, co-morbidities, disease location, previous treatment history, drug resistance pattern and time period related to economic crisis were analyzed. In order to determine independent risk factors, numeric data was compared by one sample t-test; categorical data compared by the chi-square test or the fisher exact test, and included in a logistic regression analysis, in order to analyze their association to LTFU as a dependent variable. ResultsUnivariate analysis found that LTFU patients were more likely to be immigrants (OR:2,54; 95%CI,1,36-4,75;p < 0,01); unemployed (OR:1,99; 95%CI, 1,08-3,69;p = 0,03); civil construction workers (OR:2,53; 95%CI,1,22-5,27;p = 0,01), have a history of drug (OR:3,29; 95%CI,1,57-6,91;p < 0,01), alcohol (OR:2,16; 95%CI,1,41-3,32; p < 0,01), and tobacco abuse (OR:1,60; 95%CI,1,12-2,30; p=0,02), HIV (OR:4,15; 95%CI,2,12-8,13; p < 0,01), Hepatitis C (OR:4,51; 95%CI,1,95-10,45; p < 0,01) and Hepatitis B (OR:12,97; 95%CI,3,00–56,02; p < 0,01) virus infection. Multivariate analysis found immigrants (aOR:3,08; 95% CI, 1,20-7,93; p = 0,02) and alcohol abuse (aOR:2,81; 95% CI, 1,22-6,47; p = 0,01) to be the strongest LTFU predictor. ConclusionsLTFU likelihood was strongly associated to addictive behaviours and immigrants. It is important that the medical teams prioritize these patients for intensive follow-up care. It is recommended stronger coordination with other support services such as mental health and substance abuse programs. Multidrug-resistant tuberculosis makes necessary to highlight all of the strategies available to its prevention and management; those, should include legislative responses towards recalcitrant patients, particularly when all other less restrictive measures fail.

Assessing the immediate impact of Twin-block appliance insertion on adolescents' sleep using a wearable device.

This prospective clinical study aimed to evaluate the immediate impact of Twin-block appliance insertion on the sleep of adolescents using a wearable device. A total of 24 girls, aged 11-13 years, with Class II division 1 molar relationship, skeletal class 2 malocclusion (ANB ≥5) and overjet measuring ≥5 mm were selected. Exclusion criteria included a history of previous orthodontic treatment, systemic disease, irregular sleep pattern, obstructive sleep apnea, medical history of breathing disorders, or concurrent use of medications. Participants wore a wearable device to measure sleep parameters, including deep sleep, light sleep, minutes awake during sleep, wake-up times, bedtimes and total sleep times. The participants wore the device for 10 days prior to Twin-block insertion and sleep data were collected for another 10 days after insertion. Following the insertion of the Twin-block appliance, there was a highly statistically significant shift in bedtime and wake-up time to later hours (P < .001). All participants experienced a highly significant delay in bedtime compared to the recommended 10 pm time (P < .001). Additionally, there was a significant increase in the duration of light sleep (P < .05). However, the effect on deep sleep, minutes awake during sleep and sleep duration was not statistically significant. None of the sleep parameters tested showed statistically significant changes between the first 5 days after Twin-block insertion with the subsequent 5 days. The immediate insertion of the Twin-block appliance disrupts sleep onset, wake-up time and light sleep during the specified period of 10 days.

Risk Factors of Tuberculosis Destroyed Lung in Patients with Pulmonary Tuberculosis and Structural Lung Diseases: A Retrospective Observational Study.

Tuberculosis destroyed lung constitutes a significant worldwide public health challenge, little is known about its associated risk factors and prognosis. Our study aimed to identify the risk factors of tuberculosis destroyed lung among pulmonary tuberculosis and structural lung diseases. Between January 2019 and December 2021, a case-control study was conducted at the Third People's Hospital of Shenzhen in China. We collected the clinical data among patients with pulmonary tuberculosis and structural lung diseases. Cases were defined as patients with tuberculosis destroyed lung. Controls were not diagnosed with the tuberculosis destroyed lung. A binary logistic regression was performed. In our study, a total of 341 patients met the inclusion criteria, including 182 cases and 159 controls. We found that age ranges of 46-60 years (aOR: 4.879; 95% CI: 2.338-10.180), >60 years (aOR: 3.384; 95% CI: 1.481-7.735); history of TB treatment (aOR: 2.729; 95% CI: 1.606-4.638); malnutrition (aOR: 5.126; 95% CI: 1.359-19.335); respiratory failure (aOR: 5.080; 95% CI: 1.491-17.306); and bronchiarctia (aOR: 3.499; 95% CI: 1.330-9.209) were the independent risk factors for tuberculosis destroyed lung. Conversely, having a normal (aOR: 0.207; 95% CI: 0.116-0.371) or overweight BMI (aOR: 0.259; 95% CI: 0.090-0.747) emerged as a protective factor against tuberculosis destroyed lung. This study indicated that tuberculosis destroyed lung is a common condition among patients with pulmonary tuberculosis and structural lung diseases. The independent risk factors for tuberculosis destroyed lung were identified as being within the age groups of 46-60 and over 60 years, having a previous history of TB treatment, malnutrition, respiratory failure, and bronchiarctia. It is essential to closely monitor patients possessing these risk factors to prevent the progression towards tuberculosis destroyed lung.

Benefits managers’ attitudes toward obesity treatment coverage

Despite the existence of effective treatments, obesity continues to present a severe public health crisis. Limited access to treatments works against efforts to reduce obesity prevalence. A major barrier to treatment access is a lack of insurance coverage. This study focused on an important population of stakeholders: benefits managers. The purpose of this study was to explore the relationships between attitudes about insurance coverage of obesity treatments and obesity stigma. Benefits managers have the ability to advocate for insurance coverage of medical interventions. We assessed whether attitudes toward covering obesity benefits for employees could be modified by receiving targeted information or were associated with particular factors. We recruited participants from Dun & Bradstreet’s employer database using emails. Participants were randomized to one of three conditions that provided written information about: (1) prevalence of obesity (control), (2) prevalence + financial implications of obesity, and (3) prevalence + physiology of obesity. Questionnaires were self-administered online. The response rate was 4.8%, with 404 participants meeting eligibility criteria. While attitudes toward coverage of obesity interventions did not differ significantly based on condition (p > 0.05), gender, history of previous obesity treatment, and an individual’s likelihood to attribute obesity to biological and environmental factors showed significant associations with supporting coverage of obesity treatment (p < 0.05). Findings suggest that understanding obesity as a condition caused by biological factors as opposed to personal responsibility and behavior is associated with greater support for coverage of all its treatments.

Behavioral Patterns Toward Preventive Dental Care at School Dental Camps: An Observational Study in Bengaluru.

Background Dental behavior management problems of children towards preventive dental careat school dental camps in India remain largely undocumented. This study aimed to assess such behavior patternsin preschool and school-age children at a school dental health camp. Materials and methods The cross-sectional study included 462 children, with 261 children each in the preschool (three to five years old) and school (six to 12 years old) age groups in Bengaluru. On the school dental camp day, theirbehavior and anxiety were gauged using the Frankl Behavior Rating Scale and the Raghavendra, Madhuri, and Sujata Pictorial Scale, respectively. The Chi-square test was used to uncover predictive variables for children's behavior patterns towardpreventivedental procedures at the dental school camps. Results A high prevalence of definitely negative Frankl Behavior Rating Scale ratings (59%, n=272) and dental anxiety (53%, n=245) were noted among the participants. Age, sex, the area of residence of the child, and the previous history of dental visits and treatment were predictors of their behavior at a school dental camp setup. Conclusion The present study gives an insight into the behavior of children towards preventive dental care at a school dental campin a mobile dental van, stressing the need for behavior assessment before the treatment.

Determinants of drug-resistant tuberculosis in Hunan province, China: a case-control study

BackgroundDrug-resistant tuberculosis (DR-TB) is a major public health threat in Hunan Province, with an increasing clinical burden in recent years. This study aimed to identify socio-demographic and clinical factors associated with DR-TB in Hunan province, China.MethodsA case-control study was conducted in Hunan province. Cases were all DR-TB patients who were confirmed by culture and Drug susceptibility testing (DST) and enrolled at the DR-TB treatment center of Hunan Chest Hospital from 2013 to 2018. Controls were all Drug Susceptible TB (DS-TB) patients confirmed by DST and enrolled at the same hospital during the same period. A multivariable logistic regression model was fitted to identify factors significantly associated with DR-TB.ResultsA total of 17,808 patients (15,534 DS-TB controls and 2274 DR-TB cases) were included in the study, with a mean age of 42.5 years (standard deviation (SD) ± 17.5 years) for cases and 46.1 years (SD ± 19.1 years) for controls. Age 15-64 years (Adjusted odds ratio (AOR = 1.5, 95% CI; 1.4, 1.8)), ethnic minorities (AOR = 1.5; 95% CI; 1.4, 1.8), and a history of previous TB treatment (AOR) = 1.84; 95% CI: 1.57, 2.15) was significantly associated with DR-TB. Being resident in a province outside Hunan was also a significant risk factor (AOR = 1.67; 1.27, 2.21) for DR-TB.Conclusion and recommendationsTo prevent the occurrence of DR-TB in Hunan Province, interventions should be targeted at high-risk demographic groups such as ethnic minorities, individuals of productive age, and residents living outside the province. Interventions must also be targeted to previously treated cases, suggesting the appropriateness of diagnosis, treatment, and follow-up. Understanding the risk factors at the province level helps design strategies for controlling DR-TB due to variations by socioeconomic differences, quality of health care, and healthcare access.

Risk Factor Analysis of Drug-Resistant Tuberculosis in Tuberculosis Patients at Level II Health Facilities in Depok City

Based on Global Tuberculosis Report In 2022, Indonesia will be among the 10 countries contributing to the highest incidence of drug-resistant tuberculosis each year. There are 12,794 cases of drug-resistant tuberculosis in Indonesia with 7,884 cases starting treatment. The number of drug-resistant tuberculosis cases involves a variety of risk factors. This study aims to analyze the risk factors associated with drug-resistant tuberculosis. The research method is observational analytic design case control study. The research samples were patients with drug-resistant tuberculosis and drug-sensitive tuberculosis in Depok City Health Facilities for the period March 2022–May 2023. Data were collected using questionnaires and SITB (Tuberculosis Information System). Bivariate analysis using Chi Square, while multiple logistic regression multivariate analysis. The results of the study of 73 cases and 73 controls showed that the majority were aged 18 - 65 years, 89% of cases and 62% of controls, male gender was the most dominant, 64.4% of cases and 52% of controls, most of the respondents did not work 68.5 % of cases and 53.4% ​​of controls, most of them had low income, 82.8% of cases and 62% of controls. Most of the case group had a high level of education, namely 58.5%. Meanwhile, most of the control group had low education, 50.7%. Bivariately, risk factors associated with drug-resistant tuberculosis are HIV, history of previous treatment, adherence to taking medication and the role of drug swallowing supervisor (PMO). Based on multivariate analysis, the dominant variable associated with the incidence of drug-resistant tuberculosis is history of previous treatment (OR6.021 with CI 2.055-18.721) meaning that patients with a history of previous treatment have a 6 times risk of developing drug-resistant tuberculosis compared to patients without a history of previous treatment.

Evaluating the Effect of the Demographic, Trichoscopic and Laboratory Characteristics on The Recurrence of Alopecia Areata.

Alopecia areata (AA) has diverse disease characteristics and multiple factors may interfere with the prognosis of the disease. In this study, the factors affecting the AA recurrence were evaluated. A total of a hundred patients diagnosed with AA between June 2022 and March 2023 were included in this retrospective, cross-sectional study. The patients were divided into two groups according to the presence of outbreaks. Both groups were compared in terms of age, gender, disease duration, number of outbreaks, family history of AA, previous medical treatment history for AA, clinical type, disease severity, presence of accompanying nail findings, and trichoscopic and laboratory characteristics. Among 100 patients, male dominance was found (N = 69). Most of the patients had patchy disease (90/100), mild disease severity (88/100), and a solitary outbreak (65/100). Male gender, longer disease duration, family history, presence of S2 severity of alopecia tool score, trachyonychia, short vellus hairs in trichoscopic examination, hypothyroidism, and folic acid deficiency were factors for AA outbreaks. Male gender and the presence of a family member with AA in the family were defined as the independent prognostic factors for disease recurrence. While demographic, laboratory, and clinical findings are factors for AA outbreaks in the follow-up, male gender and family history should be considered independent predictors.

Impact of anti-CGRP monoclonal antibodies on central sensitization level in migraine patients

Background. Central sensitization (CS) is the mechanism underlying chronic migraine and other conditions combined into a group of central sensitivity syndromes. The most reliable method for assessing the severity of CS is Central Sensitization Inventory (CSI).Aim. The aim of our study is the evaluation of anti-CGRP monoclonal antibodies (erenumab, fremanezumab) effect on the central sensitization level in migraine patients.Material and methods. We recruited 90 patients over 18 years old diagnosed with episodic migraine (EM) and chronic migraine (CM) according to the International Classification of Headache Disorders, 3rd edition. All patients were from November 2020 to March 2022. Demographic data, history of migraine and previous migraine treatment were collected for each patient. All patients filled out CSI. Dynamics was followed up monthly with headache diaries.Results. After six months of treatment the level of CS in the CM group significantly decreased from the initial level of 41 (32.0, 50.5) to 36 (25.0, 39.0), which corresponds to the absence of clinically significant CS, p = 0.02*. The analysis of points of the CSI after 3 months of treatment shows a significant decrease in the prevalence of pain syndromes, cognitive impairment, asthenic disorders, hypersensitivity and affective disorders.Conclusions. The use of erenumab and fremanezumab is advisable in patients with migraine and comorbid conditions based on the CS mechanism.

Prevalence of Enterococcus faecalis and Candida albicans in endodontic retreatment Cases: A comprehensive study

IntroductionEndodontic treatment failures often stem from the presence of microbial pathogens, particularly Enterococcus faecalis and Candida albicans. This study systematically assesses the prevalence of E. faecalis and C. albicans in endodontic retreatment cases, aiming to explore their impact on treatment outcomes. MethodsEmploying a systematic sampling approach, 30 patients with a history of previous endodontic treatment were selected. Rigorous clinical and radiographic assessments were conducted, following standardized protocols for root canal sample collection. Microbiological analysis, utilizing selective culture media, was employed to identify and quantify E. faecalis and C. albicans. Statistical analyses, including chi-square and logistic regression tests, were performed. ResultsThe study involved 30 patients undergoing endodontic retreatment, with comprehensive clinical and radiographic evaluations for cases with and without periradicular lesions. Microbiological analysis unveiled a significant prevalence of E. faecalis and C. albicans, establishing a robust association between these pathogens and retreatment failure. These findings underscore the critical need for targeted antimicrobial interventions to enhance the overall success rates of endodontic retreatment procedures. ConclusionThis study highlights the substantial prevalence of E. faecalis and C. albicans in endodontic retreatment cases, emphasizing the importance of identifying and effectively managing these pathogens for successful treatment outcomes. The notable association between these microbial agents and retreatment failure underscores the imperative for tailored antimicrobial strategies to enhance the efficacy of endodontic retreatment procedures.

Risk indicators for gingival recession in the esthetic zone: A cross-sectional clinical, tomographic, and ultrasonographic study.

To evaluate the risk indicators associated with midfacial gingival recessions (GR) in the natural dentition esthetic regions. Cone-beam computed tomography (CBCT) results of thirty-seven subjects presenting with 268 eligible teeth were included in the cross-sectional study. Clinical measurements included presence/absence of midfacial GR; the depth of the midfacial, mesial, and distal gingival recession; the recession type (RT); keratinized tissue width (KT); and attached gingiva width (AG). Questionnaires were utilized to capture patient-reported esthetics and dental hypersensitivity for each study tooth. Buccal bone dehiscence (cBBD) and buccal bone thickness (cBBT) were measured on the CBCT scans. High-frequency ultrasonography was performed to assess gingival thickness (GT) and buccal bone dehiscence (uBBD). Intraoral optical scanning was obtained to quantify the buccolingual position of each study site (3D profile analysis). Multilevel logistic regression analyses with generalized estimation equations were performed to assess the factors associated with the conditions of interest. The presence of midfacial GR was significantly associated with the history of periodontal treatment for pocket reduction (OR 7.99, p=0.006), KT (OR 0.62, p<0.001), cBBD (OR 2.30, p=0.015), GT 1.5mm from the gingival margin (OR 0.18, p=0.04) and 3D profile 1mm from the gingival margin (OR 1.04, p=0.001). The depth of midfacial GR was significantly correlated to previous history of periodontal treatment (OR 0.96, p=0.001), KT (OR -0.18, p<0.001), presence of bone fenestration (OR 0.24, p=0.044), and cBBD (OR 0.43, p<0.001). The depth of midfacial GR was also the only factor associated with patient-reported esthetics (OR -3.38, p=0.022), while KT (OR 0.77, p=0.018) and AG (OR 0.82, p=0.047) were significantly correlated with patient-reported dental hypersensitivity. Several risk indicators of midfacial and interproximal GR in the esthetic region were identified. The use of imaging technologies allowed for detection of parameters associated with the conditions of interest, and, therefore, their incorporation in future clinical studies is advocated. Ultrasonography could be preferred over CBCT for a noninvasive assessment of periodontal phenotype.

Predictors of Death in Rifampicin Resistant Tuberculosis Patients Treated with the Short Course in Conakry, Guinea.

The emergence of rifampicin-resistant tuberculosis (RR-TB) is a major issue for TB control programs due to high risk of treatment failure and death. The objective of this study was to describe survival and to determine predictors of death in RR-TB patients treated with the short regimen (9-11 months) in the Conakry TB treatment centers. Sociodemographic, clinical, and survival data were collected prospectively between 2016 and 2021 on RR-TB patients in the Department of Pneumo-Phtisiology, the Carrière and the Tombolia TB centers. The Kaplan-Meier method was used to estimate the cumulative incidence of death of patients. The Cox regression model was used to identify the predictors independently associated with death. Of 869 patients, 164 (18.9%) patients died during treatment, 126 of them within 120 days of treatment initiation. The factors associated with death during treatment were as follows: patients treated in the Carrière TB center (adjusted hazard ratio [aHR] = 1.65; 95% CI: 1.06-2.59) and in the Department of Pneumo-Phtisiology (aHR = 3.26; 95% CI: 2.10-5.07), patients ≥ 55 years old (aHR = 4.80; 95% CI: 2.81-8.19), patients with no history of first-line TB treatment (aHR = 1.51; 95% CI: 1.05-2.16), and patients living with HIV (aHR = 2.81; 95% CI: 1.94-4.07). The results of this study can help the national TB control program to reconsider its therapeutic strategy to improve patient care in case of RR-TB. Large prospective clinical studies should be conducted to provide evidence of the impact of such factors like previous history of TB treatment and HIV infection on survival of RR-TB patients.

Incidence of side effects of antituberculosis drugs and their related factors in northern Iran: a retrospective cohort study.

Antituberculosis drugs may cause mild, moderate or severe adverse drug reactions (ADR) leading to poor compliance. Description of the pattern of ADR and their related factors can help tuberculosis (TB) control program as part of the WHO programs. This study aims to investigate the incidence of ADR and associated factors among TB patients in northern Iran. This is a retrospective cohort study. The required information, including year of diagnosis, age, gender, residence area, nationality, HIV co-morbidity, history of anti TB treatment and ADR, was obtained from the Deputy of Health, Mazandaran University of Medical Sciences, Iran. All data were analyzed using SPSS version 21 software. Out of 3903 TB patients, 136 (3.5%) experienced major ADR. The incidence of ADR for men and women as well as for those with and without previous treatment history were 3.9% vs. 3.3% and 5.3% vs. 3.4%, respectively (p>0.05). Multiple logistic regression models showed a higher chance of ADR among those aged over 59 compared with those aged under 29 (OR=2.63, 95% confidence interval: 1.54-4.49). Age over 59 can be considered a risk factor for ADR with anti-TB drug administration.

Determinants of sputum culture conversion time in multidrug-resistant tuberculosis patients in ALERT comprehensive specialized hospital, Addis Ababa, Ethiopia: A retrospective cohort study.

The treatment response of multi-drug resistance tuberculosis (MDR-Tuberculosis) patients is mainly dictated by the sputum culture conversion. An earlier culture conversion is a remarkable indicator of the improvement in the treatment response. In this study, we aimed to determine the time to culture conversion and its associated factors among MDR-Tuberculosis patients in All Africa Leprosy, Tuberculosis and Rehabilitation Training Center (ALERT) Hospital, Addis Ababa, Ethiopia. A retrospective cohort study was conducted on 120 MDR-Tuberculosis patients attending ALERT Hospital from 2018-2022. Kaplan-Meier methods were used to determine the time to initial sputum culture conversion. All relevant laboratory, socio-demographic characteristics, and other clinical data were collected by chart abstraction using a structure data extraction form. The log-rank test was used to determine the survival rate. To identify the predictors of culture conversion, bivariate and multivariate Cox proportional hazard regression analysis was used. The hazard ratio (HR) with a 95% confidence interval was used to estimate the effect of each variable on the initial culture conversion. A test with a P value of < 0.05 was considered statistically significant. From the total of 120 study participants, 89.2% (107/120) have shown a successful culture conversion. The median age of the participants was 30 years (IQR = 12). The study participants were followed for 408.6 person-months (34.05 person-years). The median time to initial sputum culture conversion was 80 days. The median time to initial sputum culture conversion among HIV-positive and HIV-negative participants was 61 days (IQR = 58-63.5) and 88 days (IQR = 75-91), respectively. HIV-negative and patients with previous treatment history were shown to be the predictor for a prolonged time to initial sputum culture conversion, (aHR = 0.24 (95% CI: 0.1-0.4), P value <0.001) and (aHR = 0.47 (95% CI: 0.31-0.71), P value <0.001) respectively. The median time to sputum culture conversion for HIV positive was found to be 61 days in our study. Notably, patients with a history of previous anti-tuberculosis treatment, HIV-negative status, and higher bacillary load at baseline exhibited delayed culture conversion. These findings underscore the importance of considering such patient characteristics in the management of MDR-TB cases, as tailored interventions and close monitoring may lead to more favorable treatment outcomes. By identifying individuals with these risk factors early in the treatment process, healthcare providers can implement targeted strategies to optimize patient care and improve overall treatment success rates in MDR-TB management programs.